25.4 Valid Application

A valid applicationA request for BadgerCare Plus coverage. The request must be on the Department's application or registration form and must contain name, address, and a valid signature. The applicant must submit a signed and completed application form to complete the application process. for BadgerCare Plus must include the applicant’s:

Name, and
Address, and a
Signature in the Rights and Responsibilities section of one of the following forms:
- Wisconsin Medicaid for the Elderly, Blind and Disabled Application / Review Packet (F-10101),
- Medicaid, BadgerCare Plus and Family Planning Services Registration Application (F-10129),
- BadgerCare Plus Application Packet (F-10182),
- BadgerCare Plus Supplement to FoodShare Wisconsin Application (F-10138) or an electronic signature in ACCESS,
- Application for Health Coverage & Help Paying Costs from the Federally-facilitated Marketplace
- Telephonic signature in CARES
- Electronic signature in CARES
- Electronic signature in an account transfer from the Marketplace.

The date the BadgerCare Plus paper or ACCESS application received by the IM agency with the applicant’s name, address and a valid signature (25.5) is the filing date . Applications must be processed within 30 days of the filing date. (See 25.7)

For applications assessed as Medicaid eligible that were filed at the Marketplace and subsequently determined eligible for BadgerCare Plus or the Medicaid, the filing date for the BadgerCare Plus or Medicaid coverage will be the date the application was submitted to the Marketplace. Marketplace-referred applications must be processed within 30 days of the date the Marketplace application was received by the consortium or agency. For additional information about the filing date, see 25.6.

This page last updated in Release Number: 13-02

Release Date: 10/25/13

Effective Date: 10/01/13